Cytokine Levels in Critically Ill Patients With COVID-19 and Other Conditions

September 3, 2020

Kox M, Waalders NJB, Kooistra EJ, et al.

JAMA

This study compares cytokine levels in critically ill patients with COVID-19 vs. levels in patients with other critical illnesses. All patients were admitted to the intensive care unit (ICU) of Radboud University Medical Center. Plasma concentrations of the proinflammatory cytokines tumor necrosis factor (TNF), IL-6, and IL-8 were determined in consecutive mechanically ventilated patients with COVID-19. Patients with immunological insufficiencies were excluded. Cytokines in all cohorts were determined using the same methodology (Milliplex assay).There were 46 patients with COVID-19 with ARDS, 51 with septic shock with ARDS, 15 with septic shock without ARDS, 30 with OHCA, and 62 with multiple traumas. There were no significant differences in sex or age between patients with COVID-19 and other patient groups. In COVID-19, cardiovascular insufficiency was more common, overall disease severity and leukocyte counts were lower, and lung injury was more severe than the other groups. Levels of all 3 cytokines were significantly lower in patients with COVID-19 than in patients with septic shock with ARDS. TNF levels in patients with COVID-19 were higher than those in trauma patients. The findings of this preliminary analysis suggest COVID-19 may not be characterized by a cytokine storm.

Kox M, Waalders NJB, Kooistra EJ. Cytokine Levels in Critically Ill Patients With COVID-19 and Other Conditions. JAMA. 2020; 324(15). DOI:10.1001/jama.2020.17052

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